Melanoma biopsy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.; Serge Korjian M.D.

Biopsy

• Patients who have lesions suspected to be melanoma should always be biopsied.
• An excisional biopsy (either elliptical, punch, or sauceritazation) of the thickest portion of the lesion with 1-3 mm margins is recommended.
• Shave biopsy is acceptable only when the index of suspicion for melanoma is low.
• The following should be reported when a biopsy is being reported:

• Location
• Regression
• Tumor infiltrating lymphocytes
• Breslow thickness and vertical growth phase
• Histologic ulceration
• Clark level
• Angiolymphatic invasion
• Neurotropism
• Histologic subtype

{{familytree | F01 | | F02 | | F03 | | F04 | | F05 | | F06 | F01=Breslow thickness|E02=Ulceration status|E03=Mitotic rate|E04=Depth and peripheral margin status|E05=Presence of satellitosis|E06=Clark level for lesions ≤ 1 mm

Suspicious pigmented lesion

Biopsy

Inadequate

Rebiopsy

Melanoma confirmed

Reassessment with complete physical examination, including neurological exam and lymph node assessment

Staging

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